HRT, Perimenopause, and FTP

Ladies (and any gents with knowledge via the females in their lives)

Are you on HRT (if so what type)?
When did you make the decision?
Has it impacted your FTP/ability to train/race results, either positively or negatively?

I’d really appreciate any feedback.

Thanks :slight_smile:


To start with, I’m not female, although I’ve been married for 38 years. My wife did not start HRT, and has undergone significant changes through menopause, not the least of which is significant weight gain and decrease in physical activity. HRT has been avoided because of the WHI (Woman’s Health Initiative), a study that supposedly showed an increased risk of breast cancer. Regardless of what you might think of him, Peter Attia does a good discussion of the issues in one of his podcasts. I think if we knew then what we know now, HRT would have been taken.

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50 yo in peri here. Decided not to do HRT (so far) because my symptoms haven’t been too bad. I’m not opposed to it, just haven’t felt that I need it.
My weight hasn’t changed in the past 5 years, I did manage to increase my FTP by about 5w this year. I added strength training starting about 3 years ago, I’d be ok with gaining a bit of weight so long as some if it is muscle. I get a dexa next month so it will be interesting to compare body composition to 5 years ago.
The main difference I notice these days is that I can’t do too many back to back hard efforts. I did a stage race last year and by day 4 really struggled to get my heart rate up, legs felt heavy. My endurance seems to be better than ever at this age but my top end is definitely not there any more.

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I’m not female, but I do have a spouse who is in peri and together we have done quite a bit of research on it. The podcast Hit play not Pause has been a lot of help in not only gathering information but also for her a source of support. It’s here: Podcast

She will be starting TRT in the coming months. She just had a hip surgery that she’s recovering from so have to wait until that’s settled. Having a good doctor who is up on the latest literature is essential!

Her decision was based on her overall motivation levels, weight gain, and sports performance decline. She is only 41 so a bit young to have these sorts of symptoms.

Hope this was helpful! I’m happy to pass along any questions to her.


48yo in peri here.
I started using OTC creams about 2 years ago because I was having massive mood swings and was just not feeling like “myself”, probably mildly depressed, and I was getting incredibly constipated. I was also having some disrupted sleep. My gyno suggested antidepressants (which I firmly rejected) and said that there was a progesterone OTC cream I could try (Emerita {now Life-Flo} Pro-Gest). After lots of reading about HRT, I decided to do the OTC cream because I thought (a) it was easy to adjust the amount with a cream I apply myself, and (b) it wasn’t a big commitment - somehow a prescription felt like a big commitment. Long story short: I use the Emerita/Life-Flo Pro-Gest and Estriol creams, very small amounts but enough that I totally feel the difference - I feel like ME again. That’s what is important to me. I still sometimes run hot when sleeping, but I’m not waking up at 2am and not being able to go back to sleep.

I do not notice a difference in being able to train or race - I’ve had other things that have impacted that (2022 was impacted by an injury at the end of 2021 and then covid mid-season that was very hard to recover from, and 2023 seemed to just not go as well as I wanted in general, but I don’t think it was hormone related…). I might be better off with slightly more estrogen - the last time I had my hormones checked my gyno NP suggested increasing the amount of estrogen - and maybe I’ll try that sometime soon, but so far I haven’t felt the need.

The main resource I used was Dr. Avrum Bluming and Carol Tavris’s book Estrogen Matters, which I found after listening to them on this Hit Play Not Pause podcast episode.

Hope this is helpful.


Thank you so much everyone who has posted here. Appreciate the input. I will listen to that podcast today.

I don’t really want the hassle and cost of being on medication and, other than some weeks of terrible bloating (as you ladies know, carrying 3kgs of water weight does nothing for watts/kilo!) and wanting to kill everyone, I am mostly sane and feel ok. However, I am also keen not to age before my time. I’m 46 now and it’s been a rollercoaster over physical changes over the last 3 or so years, changing from a regular as clockwork 24 day cycle, to massive bleeds initially that went on for months along with something that resembled morning sickness, to now where I haven’t had a proper bleed since 19th of December. The doctors were initially sceptical it wasn’t something more sinister so sent me for all sorts of horrid, painful intrusive tests, all of which came back clear.

I feel like HRT may prolong my ability to keep improving, and keep muscle that I will otherwise struggle to hold on to. I am dreading the initial steps of finding the right dose as I have had a terrible time historically with the contraceptive pill but hoping it may be easier to negotiate as the dosage is more flexible than with the pill.


Hey folks, just a quick update to say I started listening to the ‘Hit Play not Pause’ podcast (link repeated below for reference, and it is utterly brilliant. It has totally changed my outlook on the entire thing. Thank you so much for recommending. My biggest problem now is whether to listen to the TR podcast back episodes, or this :rofl:


I find only some of the episodes of that podcast to be interesting. The one I had specifically referenced was a game-changer for me, and the episodes where the guests are talking about medical aspects are also really interesting, but I guess like all podcasts there are certain “themes” that I find get old. So I tend to pick and choose the episodes I want to listen to, and the ones I do listen to are typically terrific. YMMV. But glad you found this - it really does have some incredibly useful information in it! And I hope all of the information helps ease your journey.

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I’m 48 and started hrt 4 weeks ago. I’m extremely happy with it. I’ve been able to lift heavier weights and my cycling watts have gone up as well. I don’t know if this is the effect of the hrt or just training but I’ll take the improvements either way.